Leitfaden Basis DE (STU3)

Basisprofil Medikations-Verordnung (MedicationRequest)

Canonical URL: http://fhir.de/StructureDefinition/medicationrequest-de-basis/0.2

medicationrequest-de-basis-0.2 (MedicationRequest)	I		MedicationRequest	There are no (further) constraints on this element Element id MedicationRequest Short description Ordering of medication for patient or group Alternate names Prescription, Order Definition An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns. Data type MedicationRequest Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative `contained.text.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource `contained.where(('#'+id in %resource.descendants().reference).not()).empty()` Mappings rim: Entity. Role, or Act workflow: ..Request script10.6: Message/Body/NewRx rim: CombinedMedicationRequest w5: clinical.medication
id	Σ	0..1	id	There are no (further) constraints on this element Element id MedicationRequest.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id MedicationRequest.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. Data type Meta
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id MedicationRequest.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. Data type uri
language		0..1	codeBinding	There are no (further) constraints on this element Element id MedicationRequest.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. Common Languages (extensible)
text	I	0..1	Narrative	There are no (further) constraints on this element Element id MedicationRequest.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later. Data type Narrative Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id MedicationRequest.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Data type Resource Mappings rim: N/A
extension		0..*	Extension	Element id MedicationRequest.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Mappings rim: N/A
rezept-zusatzinfos	I	0..1	Extension(Complex)	Element id MedicationRequest.extension:rezept-zusatzinfos Short description Rezept-Zusatzinformationen Alternate names extensions, user content Definition Zusatzinformationen im Kontext von Rezepten (Medikations-Verordnungen) Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Complex) Extension URL http://fhir.de/StructureDefinition/rezept-zusatzinfos/0.2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A rim: n/a
modifierExtension	?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
identifier		0..*	Identifier	There are no (further) constraints on this element Element id MedicationRequest.identifier Short description External ids for this request Definition This records identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. For example a re-imbursement system might issue its own id for each prescription that is created. This is particularly important where FHIR only provides part of an entire workflow process where records must be tracked through an entire system. Data type Identifier Mappings workflow: …identifer script10.6: Message/Header/PrescriberOrderNumber v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number rim: .id w5: id
definition	Σ	0..*	Reference(ActivityDefinition \| PlanDefinition)	There are no (further) constraints on this element Element id MedicationRequest.definition Short description Protocol or definition Definition Protocol or definition followed by this request. Data type Reference(ActivityDefinition \| PlanDefinition) Mappings workflow: …definition rim: .outboundRelationship[typeCode=DEFN].target[classCode=unspecified]
basedOn	Σ	0..*	Reference(CarePlan \| MedicationRequest \| ProcedureRequest \| ReferralRequest \| MedicationRequest, deutsches Basisprofil (Version 0.2))	Element id MedicationRequest.basedOn Short description What request fulfills Definition A plan or request that is fulfilled in whole or in part by this medication request. Data type Reference(CarePlan \| MedicationRequest \| ProcedureRequest \| ReferralRequest \| MedicationRequest, deutsches Basisprofil (Version 0.2)) Mappings workflow: …basedOn rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
groupIdentifier	Σ	0..1	Identifier	Element id MedicationRequest.groupIdentifier Short description gruppierender (zusammenfassender) Identifikator Definition Ein Identifikator, der allen MedicationRequests gemeinsam ist, die annähernd zur selben Zeit vom selben Autor für den selben Patienten erstellt wurden. Dies kann beispielsweise zur Gruppierung für die in Deutschland üblichen 1..3 Verordnungen auf einem (Papier-)Rezept verwendet werden. Requirements Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation. Data type Identifier Mappings workflow: …groupIdentifier rim: .outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
status	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationRequest.status Short description active \| on-hold \| cancelled \| completed \| entered-in-error \| stopped \| draft \| unknown Definition A code specifying the current state of the order. Generally this will be active or completed state. Comments This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription MedicationRequestStatus (required) Mappings workflow: …status script10.6: no mapping rim: .statusCode w5: status
intent	Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id MedicationRequest.intent Short description proposal \| plan \| order \| instance-order Definition Whether the request is a proposal, plan, or an original order. Comments It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. Data type code Binding The kind of medication order MedicationRequestIntent (required) Mappings workflow: …intent rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere) w5: class
category		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id MedicationRequest.category Short description Type of medication usage Definition Indicates the type of medication order and where the medication is expected to be consumed or administered. Data type CodeableConcept Binding A coded concept identifying where the medication ordered is expected to be consumed or administered MedicationRequestCategory (preferred) Mappings script10.6: Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value w5: class
priority	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationRequest.priority Short description routine \| urgent \| stat \| asap Definition Indicates how quickly the Medication Request should be addressed with respect to other requests. Data type code Binding Identifies the level of importance to be assigned to actioning the request MedicationRequestPriority (required) Mappings workflow: …priority rim: .priorityCode w5: grade
medication[x]	Σ	1..1		There are no (further) constraints on this element Element id MedicationRequest.medication[x] Short description Medication to be taken Definition Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications. Comments If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource. . Binding A coded concept identifying substance or product that can be ordered. SNOMED CT Medication Codes (example) Mappings workflow: …code script10.6: Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription v2: RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code rim: consumable.administrableMedication w5: what
medicationCodeableConcept			CodeableConcept	Data type CodeableConcept
medicationReference			Reference(Medication \| Medication, deutsches Basisprofil (Version 0.2))	Data type Reference(Medication \| Medication, deutsches Basisprofil (Version 0.2))
subject	Σ	1..1	Reference(Patient \| Group \| Patient, deutsches Basisprofil (Version 0.2))	Element id MedicationRequest.subject Short description Who or group medication request is for Definition A link to a resource representing the person or set of individuals to whom the medication will be given. Comments The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified. Data type Reference(Patient \| Group \| Patient, deutsches Basisprofil (Version 0.2)) Mappings workflow: …subject script10.6: Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT) v2: PID-3-Patient ID List rim: .participation[typeCode=AUT].role w5: who.focus
context		0..1	Reference(Encounter \| EpisodeOfCare)	There are no (further) constraints on this element Element id MedicationRequest.context Short description Created during encounter/admission/stay Definition A link to an encounter, or episode of care, that identifies the particular occurrence or set occurrences of contact between patient and health care provider. Comments SubstanceAdministration->component->EncounterEvent. Data type Reference(Encounter \| EpisodeOfCare) Mappings workflow: …context script10.6: no mapping v2: PV1-19-Visit Number rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"] w5: context
supportingInformation		0..*	Reference(Resource)	There are no (further) constraints on this element Element id MedicationRequest.supportingInformation Short description Information to support ordering of the medication Definition Include additional information (for example, patient height and weight) that supports the ordering of the medication. Data type Reference(Resource) Mappings rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)] w5: context
authoredOn	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationRequest.authoredOn Short description When request was initially authored Definition The date (and perhaps time) when the prescription was initially written or authored on. Data type dateTime Mappings workflow: …authoredOn script10.6: Message/Body/NewRx/MedicationPrescribed/WrittenDate v2: RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction rim: author.time w5: when.recorded
requester	Σ I	0..1	BackboneElement	There are no (further) constraints on this element Element id MedicationRequest.requester Short description Who/What requested the Request Definition The individual, organization or device that initiated the request and has responsibility for its activation. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` mps-1: onBehalfOf can only be specified if agent is practitioner or device `(agent.resolve().empty()) or (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not()` Mappings workflow: …requester rim: .participation[typeCode=AUT].role w5: who.author
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.requester.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.requester.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.requester.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
agent	Σ	1..1	Reference(Practitioner \| Organization \| Patient \| RelatedPerson \| Device \| Practitioner, deutsches Basisprofil (Version 0.2) \| Organisation, deutsches Basisprofil (Version 0.2) \| Patient, deutsches Basisprofil (Version 0.2))	Element id MedicationRequest.requester.agent Short description Who ordered the initial medication(s) Definition The healthcare professional responsible for authorizing the initial prescription. Comments It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. Data type Reference(Practitioner \| Organization \| Patient \| RelatedPerson \| Device \| Practitioner, deutsches Basisprofil (Version 0.2) \| Organisation, deutsches Basisprofil (Version 0.2) \| Patient, deutsches Basisprofil (Version 0.2)) Mappings workflow: ….agent script10.6: Message/Body/NewRx/Prescriber (need detail to link to specific prescriber … Prescriber.Identification in SCRIPT) v2: RXE-13-Ordering Provider's DEA Number / RXO-14-Ordering Provider's DEA Number / RXE-14-Pharmacist/Treatment Supplier's Verifier ID / RXO-15-Pharmacist/Treatment Supplier's Verifier ID / ORC-12-Ordering Provider / PRT-5-Participation Person: PRT-4-Participation='OP' (all but last deprecated) rim: .player
onBehalfOf	Σ I	0..1	Reference(Organization)	There are no (further) constraints on this element Element id MedicationRequest.requester.onBehalfOf Short description Organization agent is acting for Definition The organization the device or practitioner was acting on behalf of. Requirements Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request. Data type Reference(Organization) Mappings workflow: ….onBehalfOf rim: .scoper
recorder		0..1	Reference(Practitioner \| Practitioner, deutsches Basisprofil (Version 0.2))	Element id MedicationRequest.recorder Short description Person who entered the request Definition The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order. Data type Reference(Practitioner \| Practitioner, deutsches Basisprofil (Version 0.2)) Mappings rim: .participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType) w5: who
reasonCode		0..*	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.reasonCode Short description Reason or indication for writing the prescription Definition The reason or the indication for ordering the medication. Comments This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference. Data type CodeableConcept Binding A coded concept indicating why the medication was ordered. Condition/Problem/Diagnosis Codes (example) Mappings workflow: …reasonCode script10.6: Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value v2: ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication rim: reason.observation.reasonCode w5: why
reasonReference		0..*	Reference(Condition \| Observation \| Observation, deutsches Basisprofil (Version 0.2) \| Deutsches Basisprofil einer Condition (Version 0.2))	Element id MedicationRequest.reasonReference Short description Condition or Observation that supports why the prescription is being written Definition Condition or observation that supports why the medication was ordered. Comments This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode. Data type Reference(Condition \| Observation \| Observation, deutsches Basisprofil (Version 0.2) \| Deutsches Basisprofil einer Condition (Version 0.2)) Mappings workflow: …reasonReference script10.6: no mapping rim: reason.observation[code=ASSERTION].value w5: why
note		0..*	Annotation	There are no (further) constraints on this element Element id MedicationRequest.note Short description Information about the prescription Definition Extra information about the prescription that could not be conveyed by the other attributes. Data type Annotation Mappings workflow: …note script10.6: Message/Body/NewRx/MedicationPrescribed/Note rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
dosageInstruction		0..*	Dosage	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction Short description How the medication should be taken Definition Indicates how the medication is to be used by the patient. Comments There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed. Data type Dosage Mappings workflow: …occurrence[x] rim: see dosageInstruction mapping
dispenseRequest		0..1	BackboneElement	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest Short description Medication supply authorization Definition Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings script10.6: Message/Body/NewRx/MedicationPrescribed/ExpirationDate rim: component.supplyEvent
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
validityPeriod		0..1	Period	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.validityPeriod Short description Time period supply is authorized for Definition This indicates the validity period of a prescription (stale dating the Prescription). Requirements Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription. Comments It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations. Data type Period Mappings script10.6: Message/Body/NewRx/MedicationPrescribed/Refills rim: effectiveTime
numberOfRepeatsAllowed		0..1	positiveInt	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.numberOfRepeatsAllowed Short description Number of refills authorized Definition An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. Comments If displaying "number of authorized fills", add 1 to this number. Data type positiveInt Mappings script10.6: Message/Body/NewRx/MedicationPrescribed/Quantity v2: RXE-12-Number of Refills rim: repeatNumber
quantity		0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.quantity Short description Amount of medication to supply per dispense Definition The amount that is to be dispensed for one fill. Data type SimpleQuantity Mappings script10.6: Message/Body/NewRx/MedicationPrescribed/DaysSupply v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system rim: quantity
expectedSupplyDuration		0..1	Duration	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.expectedSupplyDuration Short description Number of days supply per dispense Definition Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last. Comments In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage) When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors. Data type Duration Mappings script10.6: Message/Body/NewRx/MedicationPrescribed/Substitutions rim: expectedUseTime
performer		0..1	Reference(Organization \| Organisation, deutsches Basisprofil (Version 0.2))	Element id MedicationRequest.dispenseRequest.performer Short description Intended dispenser Definition Indicates the intended dispensing Organization specified by the prescriber. Data type Reference(Organization \| Organisation, deutsches Basisprofil (Version 0.2)) Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE] w5: who
substitution		0..1	BackboneElement	Element id MedicationRequest.substitution Short description aut-idem-Regelung Definition Gibt an, ob ein alternatives Präparat (identischer Wirkstoff, Dosis, Form) angegegeben werden darf. Vgl. Definition des allowed-Elements Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions rim: subjectOf.substitutionPersmission
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.substitution.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.substitution.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.substitution.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
allowed	?!	1..1	boolean	Element id MedicationRequest.substitution.allowed Short description aut-idem Definition aut-idem-Regelung. false === aut-idem := KEIN Ersetzen durch Produkt eines anderen Herstellers erlaubt true === NICHT aut-idem := Ersetzen durch Produkt eines anderen Herstellers erlaubt Comments This element is labeled as a modifer because whether substitution is allow or not cannot be ignored. Data type boolean Mappings script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status rim: code
reason		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.substitution.reason Short description Why should (not) substitution be made Definition Indicates the reason for the substitution, or why substitution must or must not be performed. Data type CodeableConcept Binding A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. SubstanceAdminSubstitutionReason (example) Mappings script10.6: not mapped v2: RXE-9 Substition status rim: reasonCode
priorPrescription		0..1	Reference(MedicationRequest \| MedicationRequest, deutsches Basisprofil (Version 0.2))	Element id MedicationRequest.priorPrescription Short description An order/prescription that is being replaced Definition A link to a resource representing an earlier order related order or prescription. Data type Reference(MedicationRequest \| MedicationRequest, deutsches Basisprofil (Version 0.2)) Mappings workflow: …replaces script10.6: not mapped rim: .outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]
detectedIssue		0..*	Reference(DetectedIssue)	There are no (further) constraints on this element Element id MedicationRequest.detectedIssue Short description Clinical Issue with action Alternate names Contraindication, Drug Utilization Review (DUR), Alert Definition Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc. Data type Reference(DetectedIssue) Mappings rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
eventHistory		0..*	Reference(Provenance)	There are no (further) constraints on this element Element id MedicationRequest.eventHistory Short description A list of events of interest in the lifecycle Definition Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource. Comments This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.). Data type Reference(Provenance) Mappings workflow: …relevantHistory rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Beispiele

XML-Format

<MedicationRequest xmlns="http://hl7.org/fhir">
    <meta>
        <profile value="http://fhir.de/StructureDefinition/medicationrequest-de-basis/0.2" />
    </meta>
    <extension url="http://fhir.de/StructureDefinition/rezept-zusatzinfos/0.2">
        <extension url="unfall">
            <valueBoolean value="true" />
        </extension>
    </extension>
    <status value="active" />
    <intent value="order" />
    <medicationReference>
        <reference value="/Medication/987654" />
    </medicationReference>
    <subject>
        <reference value="Patient/12345" />
    </subject>
    <requester>
        <agent>
            <reference value="Pracitioner/9876" />
        </agent>
        <onBehalfOf>
            <reference value="Organization/5432" />
        </onBehalfOf>
    </requester>
    <substitution>
        <allowed value="true" />
    </substitution>
</MedicationRequest>

JSON-Format

{
    "resourceType": "MedicationRequest",
    "meta": {
        "profile":  [
            "http://fhir.de/StructureDefinition/medicationrequest-de-basis/0.2"
        ]
    },
    "extension":  [
        {
            "extension":  [
                {
                    "url": "unfall",
                    "valueBoolean": true
                }
            ],
            "url": "http://fhir.de/StructureDefinition/rezept-zusatzinfos/0.2"
        }
    ],
    "status": "active",
    "intent": "order",
    "medicationReference": {
        "reference": "/Medication/987654"
    },
    "subject": {
        "reference": "Patient/12345"
    },
    "requester": {
        "agent": {
            "reference": "Pracitioner/9876"
        },
        "onBehalfOf": {
            "reference": "Organization/5432"
        }
    },
    "substitution": {
        "allowed": true
    }
}